Journal of vascular surgery. Venous and lymphatic disorders最新文献

{"title":"The new reality of artificial intelligence in health care","authors":"Elena Goranova MD, PhD ,&nbsp;Rashad A. Bishara RVPI, MSc, FRCS ,&nbsp;Alexander Lazarov PhD","doi":"10.1016/j.jvsv.2025.102360","DOIUrl":"10.1016/j.jvsv.2025.102360","url":null,"abstract":"<div><div>In our view, artificial intelligence (AI) will never substitute for a physician. Still, physicians who integrate AI into their practice may replace those who do not. With this concept in mind, this article aims to promote the concept of cautious integration of AI into patient care by explaining the fundamentals of AI.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102360"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial disparities in superficial venous disease management: A comparative study of interventions and patient-related outcomes","authors":"Garyn Metoyer MD ,&nbsp;Ethan Chervonski MD, MPH ,&nbsp;Giancarlo Speranza MD, MBA ,&nbsp;Caron B. Rockman MD ,&nbsp;Glenn R. Jacobowitz MD ,&nbsp;Thomas S. Maldonado MD ,&nbsp;Mikel Sadek MD","doi":"10.1016/j.jvsv.2025.102363","DOIUrl":"10.1016/j.jvsv.2025.102363","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Chronic venous insufficiency (CVI) resulting in venous hypertension can cause lifestyle-limiting debilitation. Studies have identified racial and ethnic disparities in CVI presentation and clinical severity; however, there is limited literature examining disparities in CVI management and procedural outcomes among different racial and ethnic groups. The aim of this study was to characterize differences in endovenous treatment paradigms between racial and ethnic groups and to assess how this affected patient outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The national Vascular Quality Initiative Varicose Vein Registry database was queried for superficial venous interventions, including endovenous radiofrequency ablation, endovenous laser ablation, high ligation, stripping, and microphlebectomy, performed from April 2014 to March 2024. We categorized patients as non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic/Latino, Asian, and Other (including American Indian, Alaskan Native, Native Hawaiian, other Pacific Islander, more than one race, and unknown/other). Baseline demographics, clinical and treatment characteristics, complication rates, and changes in quality-of-life endpoints (ie, revised Venous Clinical Severity Score [rVCSS] and Heaviness, Achiness, Swelling, Throbbing, Itching [HASTI] score) were compared between racial/ethnic groups with NHW as the reference category. Linear regression and logistic regression/χ&lt;sup&gt;2&lt;/sup&gt; tests were used to compare continuous/ordinal and categorical variables, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 65,090 superficial venous procedures encompassing endovenous thermal ablations, stripping/high ligation, and microphlebectomy were included. NHW patients underwent interventions for less severe baseline CVI based on CEAP class and had more superficial venous interventions (2.45 ± 1.95; &lt;em&gt;P&lt;/em&gt; &lt; .001) and repeat thermal ablations (1.66 ± 1.14; &lt;em&gt;P&lt;/em&gt; &lt; .001) than other groups. NHB had more severe baseline CVI based on higher prevalence of severe CEAP (ie, C5, C6, and C6r disease: 5.8%, 11.8%, and 0.9%, respectively; &lt;em&gt;P&lt;/em&gt; &lt; .05). NHB patients were less likely to have concomitant microphlebectomy than NHW (odds ratio, 0.79; 95% confidence interval, 0.73-0.87; &lt;em&gt;P&lt;/em&gt; &lt; .001). NHB had the highest rVCSS score preoperatively (8.17 ± 4.02; &lt;em&gt;P&lt;/em&gt; &lt; .001) with the largest improvement at ≤3 (−4.40 ± 5.23; &lt;em&gt;P&lt;/em&gt; &lt; .001) and &gt;3 months (−7.00 ± 5.00; &lt;em&gt;P&lt;/em&gt; &lt; .001) following intervention. Hispanic/Latinos had the highest preoperative HASTI score (10.34 ± 5.40; &lt;em&gt;P&lt;/em&gt; &lt; .001) and the largest score reduction at ≤3 months (−6.62 ± 6.51; &lt;em&gt;P&lt;/em&gt; &lt; .001). Post procedure, Hispanics and other study groups were more likely to experience blistering and medication induced ulcer (&lt;em&gt;P&lt;/em&gt; &lt; .05). The other group was less likely to experience hematoma postoperatively (&lt;em&gt;P&lt;/em&gt; &lt; .05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102363"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-pneumatic compression and its clinical utility in management of lymphedema. A position statement endorsed by the American Venous Forum and the American Venous and Lymphatic Society","authors":"Glenn R. Jacobowitz MD ,&nbsp;Ruth Bush MD, JD, MPH ,&nbsp;Ronald S. Winokur MD ,&nbsp;Joseph D. Raffetto MD","doi":"10.1016/j.jvsv.2025.102356","DOIUrl":"10.1016/j.jvsv.2025.102356","url":null,"abstract":"<div><h3>Background</h3><div>Lymphedema is a chronic, incurable condition caused by impaired lymphatic drainage, leading to progressive swelling and functional impairment. Phlebolymphedema, a subtype linked to chronic venous insufficiency (CVI), accounts for 41.8% of lower extremity lymphedema cases and contributes to an economic burden exceeding $1 billion over 5 years. Despite its high prevalence, lymphedema remains underdiagnosed and undertreated. Current management relies on compression therapy, exercise, and limb elevation, with pneumatic compression devices (PCDs) as adjuncts. However, PCDs present limitations, including user immobilization, poor adherence, and inadequate muscle pump activation, highlighting the need for more effective, patient-centered therapies.</div></div><div><h3>Methods</h3><div>This paper evaluates the use of a non-pneumatic compression device (NPCD) that integrates static compression, sequential gradient compression (distal to proximal), and muscle pump activation.</div></div><div><h3>Results</h3><div>In two randomized controlled trials, NPCD demonstrated superior outcomes over advanced PCDs, including greater edema reduction, improved quality of life, and higher adherence rates. Unlike traditional PCDs, NPCD enables active movement during treatment, optimizing lymphatic drainage and venous return.</div></div><div><h3>Conclusions</h3><div>Given its distinctive multi-modal mechanisms and advantages, NPCD represents a clinically safe and effective, user-friendly alternative to PCDs, aligning with current best practices in vascular and lymphatic medicine. Its inclusion in future lymphedema treatment guidelines should be considered.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102356"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Symptom Duration to Histological Validation: Refining MRI Relaxation Time Biomarkers for Thrombus Chronicity in Deep Vein Thrombosis","authors":"Eniko Pomozi MD ,&nbsp;Alexander Crichton MBChB, MS ,&nbsp;Caroline Jordan MD ,&nbsp;Judit Csore MD, PhD ,&nbsp;Deborah Vela MD, MS ,&nbsp;Christof Karmonik PhD ,&nbsp;Trisha Roy MD, PhD, FRCSC, FACS1","doi":"10.1016/j.jvsv.2025.102402","DOIUrl":"10.1016/j.jvsv.2025.102402","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102402"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interesting and Different Perspective of May-Thurner Syndrome","authors":"Windsor Ting MD ,&nbsp;Viren Sehgal BS","doi":"10.1016/j.jvsv.2025.102383","DOIUrl":"10.1016/j.jvsv.2025.102383","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102383"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147394776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Laser Ablation of Tributary Varicose Veins Using a Radial Two-ring Slim Fiber: A Minimally Invasive Alternative to Stab Avulsion from a Japanese Single-Center Experience","authors":"Junichi Utoh MD, PhD","doi":"10.1016/j.jvsv.2025.102418","DOIUrl":"10.1016/j.jvsv.2025.102418","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102418"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditional Survival Probability of Submassive Pulmonary Embolism: Catheter-directed Therapy vs Anticoagulant","authors":"Hind Anan MD ,&nbsp;Sarah Rosmarin DO ,&nbsp;Marissa Jarosinski MD ,&nbsp;Elizabeth Andraska MD, MSc ,&nbsp;Rabih Chaer MD, MSc ,&nbsp;Mazen Zenati MD, MPH, PhD ,&nbsp;Natalie Sridharan MD","doi":"10.1016/j.jvsv.2025.102391","DOIUrl":"10.1016/j.jvsv.2025.102391","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102391"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental Pathophysiology From Magnetic Resonance Lymphography as the Basis for Lymphaticovenular Anastomosis Indication and Targeting","authors":"Fumio Onishi MD, PhD ,&nbsp;Shigeyoshi Soga MD, PhD","doi":"10.1016/j.jvsv.2025.102424","DOIUrl":"10.1016/j.jvsv.2025.102424","url":null,"abstract":"","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102424"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147396150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in occult cancer screening for patients with unprovoked venous thromboembolism: A narrative review of epidemiology, risk, and clinical strategies","authors":"Jianbin Wen MB ,&nbsp;Chunfang Zhang MB ,&nbsp;Fei Wu MB ,&nbsp;Qingfu Zeng MD","doi":"10.1016/j.jvsv.2025.102439","DOIUrl":"10.1016/j.jvsv.2025.102439","url":null,"abstract":"<div><h3>Background</h3><div>Venous thromboembolism (VTE) and cancer exhibit a bidirectional correlation. The probability of detecting occult cancer in unprovoked VTE patients is significantly increased, and the cancer is often diagnosed at an advanced stage. Early screening is critical for improving prognosis; however, the effectiveness of current risk stratification and screening strategies remains controversial.</div></div><div><h3>Methods</h3><div>This review systematically integrated evidence on the epidemiology, risk stratification, and screening methods for occult malignancies in individuals with unprovoked VTE.</div></div><div><h3>Results</h3><div>Cancer-induced hypercoagulability and VTE-related inflammation interact bidirectionally, promoting thrombosis and cancer progression. In terms of risk stratification, elderly patients with VTE, as well as those comorbid with diabetes, diverticular disease, dementia, or with a history of aspirin use, have a higher detection rate of occult cancer. Occult cancer may also be indicated in patients with VTE at special sites, such as splanchnic vein thrombosis, cerebral venous thrombosis, and lower extremity arterial thrombosis, as well as in those with recurrent VTE. However, the impact of sex on the presence of occult cancer in VTE patients remains controversial. International guidelines recommend limited screening as a first-line approach, because extensive screening does not significantly improve prognosis. Positron emission tomography with computed tomography scan may enhance accurate cancer diagnosis. The Registro Informatizado Enfermedad TromboEmbólica (RIETE) and Screening for Occult Malignancy in Patients with Idiopathic Venous Thromboembolism (SOME) risk scores show limited predictive efficacy, while biomarkers and machine learning models demonstrate high diagnostic efficacy, indicating their potential application.</div></div><div><h3>Conclusions</h3><div>Regular cancer screening is necessary for individuals with unprovoked VTE, and clinical practice should adopt individualized screening strategies based on risk stratification. Future research should focus on optimizing existing models and exploring the combined application of biomarkers and machine learning to improve cancer screening for this population.</div></div>","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102439"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year outcomes of ThermoBlock radiofrequency ablation in chronic saphenous vein insufficiency: A single-center experience with 910 cases","authors":"Mehmet Emre Elci MD,&nbsp;Gözde Tekin MD","doi":"10.1016/j.jvsv.2025.102357","DOIUrl":"10.1016/j.jvsv.2025.102357","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Chronic venous insufficiency is a common vascular disorder that can lead to significant morbidity if left untreated. Endovenous thermal ablation, particularly radiofrequency ablation (RFA), has become a first-line therapy owing to its high efficacy and favorable safety profile. We sought to evaluate the technical success, safety, and clinical outcomes of the ThermoBlock RFA system in patients with reflux grade 4 great saphenous vein (GSV) insufficiency.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This single-center retrospective study included 910 patients (444 males, 466 females; mean age, 45.4 ± 11.5 years) who underwent ThermoBlock RFA between March 2019 and June 2023. Clinical severity was assessed using the Venous Clinical Severity Score, and quality of life (QoL) was measured with the VEINES-QOL/Sym questionnaire. Duplex ultrasound examinations were performed at baseline and at 3, 6, 12, and 24 months. Statistical analyses used paired &lt;em&gt;t&lt;/em&gt; tests for continuous variables and Wilcoxon signed-rank tests for ordinal variables, with effect sizes reported.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Technical success at 3 months was 97.6%. The Venous Clinical Severity Score improved from 10.9 ± 2.4 to 3.6 ± 0.9 (&lt;em&gt;P&lt;/em&gt; &lt; .001; Cohen's d = 3.7), and VEINES-QOL/Sym scores increased from 60.5 ± 7.71 to 84.6 ± 8.52 (&lt;em&gt;P&lt;/em&gt; &lt; .001; Cohen's d = 3.0). The mean GSV diameter decreased from 7.33 ± 1.13 mm before the procedure to 5.39 ± 0.60 mm at 3 months and 2.94 ± 0.66 mm at 24 months (&lt;em&gt;P&lt;/em&gt; &lt; .001). No mortality or pulmonary embolism occurred; deep vein thrombosis was observed in 0.7% of patients. Minor complications included thrombophlebitis (10.3%), hyperpigmentation (11.9%), ecchymosis (10.9%), and numbness (24.7%).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;ThermoBlock RFA is a safe and effective treatment for chronic GSV insufficiency, achieving high vein closure rates, substantial symptom relief, and improved QoL with minimal major complications. Its integrated laser guidance system may enhance procedural precision and support durable long-term outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Relevance&lt;/h3&gt;&lt;div&gt;Chronic venous insufficiency is a prevalent condition that significantly impairs QoL and imposes a substantial socioeconomic burden. Endovenous thermal ablation techniques have largely replaced conventional surgery owing to their high efficacy and lower complication rates. The ThermoBlock RFA system integrates precise thermal control with laser-guided catheter positioning, potentially enhancing procedural accuracy and outcomes. In this large, single-center study of 910 patients with advanced saphenous vein insufficiency, ThermoBlock RFA achieved a 97.6% closure rate at 3 months, with marked improvements in Venous Clinical Severity Score and VEINES-QOL/Sym scores, and a low incidence of major complications. These findings support ThermoBlock RFA as a safe, effective, and reproducible first-line option for the t","PeriodicalId":17537,"journal":{"name":"Journal of vascular surgery. Venous and lymphatic disorders","volume":"14 2","pages":"Article 102357"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}